Nelson Seeks to Restore Medicaid Fee Cuts

A proposed 10-percent cut in Medicaid physician payment rates could shrink to 3 percent if lawmakers approve a recommendation from the Texas Health and Human Services Commission (HHSC).

In mid-March, Sen. Jane Nelson (R-Lewisville), chair of the Senate Finance Subcommittee for Medicaid, asked Tom Suehs, HHSC executive commissioner, to develop a list of top funding priorities. Leading Commissioner Suehs' recommendations was a proposal to restore 7 percent of the proposed 10-percent cut in physician payments for both Medicaid and the Children's Health Insurance Program.

Senator Nelson's subcommittee designated that recommendation as a top-level priority, along with proposals to:

Stop paying coinsurance for patients who receive coverage from both Medicaid and Medicare (dual eligibles) if the coinsurance would exceed the Medicaid rate;

Restore 5 percent of the proposed 10-percent cut to hospitals and other providers;

Reduce funding for labs and durable medical equipment providers by 20 percent, with the goal of mitigating those cuts by half if funds become available;

If lawmakers vote to restore the 7 percent for Medicaid physician fees, the resulting 3-percent payment cut would apply to both child and adult Medicaid services.

Meanwhile, the full proposed 10-percent cut was still in the 2012-13 budget bill voted out of the House Appropriations Committee on March 24. House Bill 1 includes total spending of $164.5 billion, a cut of $23 billion from the 2010-11 budget. The full House is scheduled to begin debating HB 1 on April 1.